In our patient, the presence of persistent thrombocytopenia, macrothrombocytes on peripheral smear, and Döhle-like inclusions initially raised suspicion for alternative causes; however, the absence of additional systemic features commonly seen in other MYH9-related disorders—such as nephropathy, sensorineural hearing loss, or cataracts—may have contributed to the initial misclassification as ITP, leading to an empiric ITP-directed treatment approach. This evidence concerns the gene MYH9 and cataract.